On Wednesday morning, Kittana Ruels, 46, rang the bell to celebrate her last chemotherapy appointment, and it was a moment of elation but not one that came without its reservations.
“It’s a rough go for this particular one, but it’s worth it because I get to live,” she remarked.
Having beat breast cancer for the second time, she is grateful and looks forward to what comes next, but she is still left with the reality that this could have been different if she had a family doctor.
“I shouldn’t have gone through all of this in the first place. So I’m still quite annoyed that that doctor didn’t follow up with me. Two different doctors from telemedicine from the same walk-in clinic did not follow up.”
Ruels first spoke to Global News in October 2023 after she was diagnosed with stage three breast cancer and had just undergone a mastectomy to remove both her breasts.
Ruels, who previously battled breast cancer in 2018, gets a yearly scan but says getting tested was more challenging when she lost her family doctor after moving to North Bay from Mississauga during the pandemic.
She went to a walk-in clinic to schedule her yearly mammogram. The clinic, run by a nurse practitioner, video conferences doctors in to see patients.
The scan, which should have happened in May 2022, happened in September 2022.
Hearing nothing back about her test results, she assumed all was normal until she found a lump in June 2023.
Still, without a family doctor, she went back to the clinic to push for another scan and then had to reach out to the hospital to request her medical records when no one followed up.
It was only then that she found out she had breast cancer, and her records showed the previous scans from the following years showed something was “highly suspicious” and required a follow-up, yet no one did.
Now, just over five months after winning a difficult and painful battle for her life, she still wonders if it’s a battle she should have had to fight in the first place.
“Now I’ve had to do all of this. Whereas last September, in the first place, when it said suspicious, that’s when they could have done the biopsy and they could have just removed it. Maybe it wouldn’t spread,” she says. “The sad thing is we’ll never know at this point.”
Despite coming out of this fight on the other side, the mother of one says it was not easy.
“Having gone through the chemo, I’ve gained a lot of weight from steroids. My body’s changed. So essentially, I’ve been mutilated. I’ve been injected with poison; that’s what chemotherapy is in the hopes that it’ll kill the cancer before it kills you. It’s essentially a poison.”
Following chemotherapy, her doctors wanted her to do a round of radiation to ensure they had gotten everything, but she had to decline.
“I can’t afford that, so I’m not going to do the radiation,” she says.
To get radiation treatment, the North Bay resident would have to travel two hours north to Sudbury, a cost she thought would be covered by the Northern Ontario Travel Grant, which provides compensation for people travelling for medical care.
With the grant, Ruels could get a hotel room for the five nights a week she would need to be in Sudbury for treatment, but there is a catch.
“Unfortunately, I live 10 kilometres too close for the Northern Ontario Travel Grant to cover the cost of me staying overnight at a hotel. So I would have to drive there and back, so that’s four hours driving, plus my wait time to get in to have the 15 minutes of radiation five days a week, five weeks is what they recommended.”
Given this and the time and cost it would take her to get the treatment, Ruels decided to forgo the extra treatment.
“It’s not a good feeling that I have to choose between two different kinds of survival,” she says.
“I have to go back to work. I’ve been off work in September, so there’s no way I can afford this. I’m going to lose my house, so I have to choose between surviving financially or having this done. So my choice is not necessarily an easy one to make.”
Though it is not an easy decision, Ruels is grateful that through all of this, she was able to get a family doctor, and they will be diligent in checking for any signs it could return in the future.
“We need doctors. It’s a crisis, and it’s turned into a privilege instead of a right. I shouldn’t have had to almost die to get a doctor.”
The Ontario College of Family Physicians reported back in October over 2.2 million people are living in Ontario without a family physician, up from 1.8 million reported by the college in November of last year.
As for what’s next for Ruels, she said she is focusing on recovery and getting her life back.
After speaking out last year, Ruels says she was invited to join the Warriors of Hope, a Dragon Boat team for breast cancer survivors. Ruels says she is excited about the new opportunity and becoming active again.
“I know that this is it. I don’t have to get another chemo treatment. I did it. So, the end is in sight, and I’m excited about the new chapter in my life. I am excited to see what else my body can do,” she said.
From her experience, Ruels hopes it helps others advocate for themselves.
“I want people to follow up. I want people to realize no news is not necessarily good news, whether you have a doctor or not.”